Method and apparatus for performing a minimally invasive total hip arthroplasty

Abstract

A method and apparatus for performing a minimally invasive total hip arthroplasty. An approximately 3.75-5 centimeter (1.5-2 inch) anterior incision is made in line with the femoral neck. The femoral neck is severed from the femoral shaft and removed through the anterior incision. The acetabulum is prepared for receiving an acetabular cup through the anterior incision, and the acetabular cup is placed into the acetabulum through the anterior incision. A posterior incision of approximately 2-3 centimeters (0.8-1.2 inches) is generally aligned with the axis of the femoral shaft and provides access to the femoral shaft. Preparation of the femoral shaft including the reaming and rasping thereof is performed through the posterior incision, and the femoral stem is inserted through the posterior incision for implantation in the femur. A variety of novel instruments including an osteotomy guide; an awl for locating a posterior incision aligned with the axis of the femoral shaft; a tubular posterior retractor; a selectively lockable rasp handle with an engagement guide; and a selectively lockable provisional neck are utilized to perform the total hip arthroplasty of the current invention.

1. A method of preparing an acetabulum of a hip joint to receive an acetabular component, comprising:
 making an anterior incision through skin and subcutaneous tissues to expose the hip joint, the anterior incision having a length of no more than about 5 cm; 
 through the anterior incision preparing the acetabulum to receive an acetabular component through the anterior incision; 
 accessing a femoral neck and a femoral head through the anterior incision; and 
 cutting along the femur to remove a cut portion from a femoral shaft, said cut portion comprising the femoral head and a portion of the femoral neck. 
 
     
     
       2. The method of  claim 1 , wherein said step of making an anterior incision comprises making said anterior incision substantially aligned with the femoral neck. 
     
     
       3. The method of  claim 1 , wherein said anterior incision has a length of about 3.75-5 cm. 
     
     
       4. The method of  claim 1 , wherein said step of preparing the acetabulum to receive the acetabular cup through said anterior incision comprises:
 in situ morselizing said cut portion as necessary for removal through said anterior incision; 
 removing said cut portion through said anterior incision; and 
 reaming the acetabulum. 
 
     
     
       5. The method of  claim 4 , wherein said step of accessing a femoral neck and a femoral head through the anterior incision comprises steps of:
 performing a blunt dissection of muscle underlying said anterior incision to expose a capsule of a hip joint; 
 incising said capsule; and 
 retracting a portion of said capsule to visually expose said femoral neck. 
 
     
     
       6. The method of  claim 1 , wherein said step of making an anterior incision comprises making an anterior incision aligned with a longitudinal axis of the femoral neck of the femur.